Healthcare Provider Details

I. General information

NPI: 1841224615
Provider Name (Legal Business Name): GREGORY LYNN NIGH ND, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 SE MADISON ST
PORTLAND OR
97214-3890
US

IV. Provider business mailing address

1221 SE MADISON ST
PORTLAND OR
97214-3890
US

V. Phone/Fax

Practice location:
  • Phone: 503-719-4806
  • Fax: 503-719-4357
Mailing address:
  • Phone: 503-719-4806
  • Fax: 503-719-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00642
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1143
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: